Provision of a coordinator has been positive associated with time-to return-to-work (RTW) in occupational rehabilitation. The aim of this study was to examine whether the provision of a coordinator could promote RTW. We also explored if having a treatment plan were more frequent among those having a coordinator.

Methods

Cohort study following sick-listed employees articipating in a viarity of Rapid-RTW-programmes (n=39) in Norway. Patients answered self-administered questionnaires, which were linked to register data on sickness absence and diagnoses. Patients who replied yes/no to “Did the program provide a person that coordinated your services?” (n=494) were included in the modelled time to first-RTW (full (100%) or partial (10-90%) work-position) and full-RTW (100% work-position) using the Kaplan-Meier method. Cox regression analysis were used to adjust for known confounding factors.

Results

The patients median age was 44 years (min-max. 20-70), 75% were female, and many had higher secondary education (43.5%). The most common diagnoses were musculoskeletal problems (49.6%) and mental health problems (21.1%). Patients had a history of sickness absence (94.3%). The coordinators were often provided by the RTW-programme (64.8%), and coordinated mostly their own services (63.7%). Patients who had a coordinator were more likely to have a treatment plan, compared to the group that did not have a coordinator (OR 24.38, 95% CI 13.3-44.8).

A significant difference in time to first RTW and full RTW was found between patients who had a coordinator, versus patients who did not have a coordinator, p<0.001, with a median of 109 days before RTW (95% CI 70-147) versus 130 days (95% CI 39-221), and a median of 178 days before RTW (95% CI 134-222) versus 239 (95% CI 160-318), respectively. This maintained significance after controlling for gender, age, history of sickness absence, educational level and living alone/with others; first-RTW HR 1.29 (95% CI 1.04-1.61), and full-RTW HR 1.35 (95% CI 1.10-1.68).

Conclusion

In this study, having a coordinator seemed to promote an earlier return-to-work, even if this coordinator most often did coordinate own services, not services between heath care, social security, and workplace. Those were also more likely to have a treatment plan.